DESCRIPTION (Provided by investigator): An estimated 16 million Americans suffer from diabetes and its complications. 160,000 die each year. Belief is strong among the medical community that for treatment to be effective, patients must become active partners in their own health care. Recently, in addition to self-glucose monitoring, medications and diet, patient education and exercise programs have received emphasis. Unfortunately, time, distance, and financial constraints often limit patient compliance and access to such programs. While the mass market embraced home videotapes nearly ten years ago, medical home education and exercise prescriptions are usually text-based. The RVision multimedica computer system allows clinicians to create high quality, patient-specific home instructional videotapes without the time and expense of traditional video production. In Phase I, video segments were produced and tested with 20 subjects. Those who received the videotapes increased their knowledge and duration of exercising compared to controls, and rated the tapes very highly. RVision Corporation proposes to complete the development of -- script, produce, and incorporate into a multimedia computer system -- additional exercise and educational segments for patients with Type I and Type II diabetes. The research will study the effectiveness of using customized education and exercise videotapes with these patients will be studied. PROPOSED COMMERCIAL APPLICATION: Sixteen million Americans have diabetes. Medical providers are increasingly looking for ways to provide high quality care at lower costs. This is especially true for the care of patients with chronic disease, and for providers who have taken on financial risk for the cost of this care. There are over 1,000 medical groups nationally who are delivering capitated (at financial risk) care to 57 million patients. Over 66 million Americans are enrolled in managed care organizations. These organizations represent a huge target market for RVision's videotapes.